Flu time approaches in Oregon with a reminder to get vaccinated and wash your hands often

View full sizeBenjamin Brink, The OregonianDr. Lara Garrett prepares to give a flu shot to William Rakel at his home in West Linn. Garrett is a physician with Housecall Providers, a nonprofit medical practice that proves in-home medical care to senior citizens and people with disabilitiese in the Portland area.

Oregon's flu season has arrived, not with a bang but with a wimper: one isolated case confirmed in
Washington County. It's impossible to predict how severely people are
going to be hit over the next few months. But we are better prepared
than during last year's surprise H1N1 pandemic, when vaccine shortages
kept many people from getting flu shots.

"This year we had
advance warning, and vaccine is available and plentiful," says Dr. John
Townes, an infectious disease specialist and associate professor at
Oregon Health & Science University.

Scientists with the
Centers for Disease Control and Prevention expect the 2009 H1N1 strain
to crop up again this winter, along with two other strains of flu. This
year's vaccine is formulated to stimulate immunity against all three.
Public health experts recommend flu shots for everyone older than 6
months, not just groups at high risk of complications. Here's what you
need to know about the flu and how to avoid it:

What exactly is the flu, and how do you know if you have it?

Influenza
is a highly infectious virus that spreads in airborne droplets spewed
by coughing and sneezing. The illness usually hits way harder than the
common cold with symptoms including sore throat, runny or stuffy nose,
aches, chills, fatigue, fever, and sometimes vomiting and diarrhea (more
common in children).

Why do influenza outbreaks always peak during winter?

Colder,
drier winter air may be the key factor because it allows flu virus to
survive longer in the environment. At low humidity, flu spread readily
between guinea pigs in experiments at Mount Sinai Medical School in New
York. But transmission dropped when researchers raised the humidity.

Oregon
State University scientist Jeffrey Shaman recently found that bouts of
unusually dry weather precede the start of many influenza outbreaks in
North America. Colder winter air holds less moisture than warm summer
air -- creating conditions more favorable for influenza virus survival
and transmission, according to Shaman. Drier-than-normal winter weather
appears to give the virus an extra boost, the study concluded.

The practical implication: humidification of indoor air may help limit the spread of influenza.

How deadly is influenza?

The
number of deaths varies widely from year to year, from as low as 3,300
to as high as 48,600, according to the latest CDC analysis. Some viral
strains are able to infect more people, cause more complications, or
both.

How well do flu shots protect people?

Flu shots
can reduce the chances of getting the flu by more than 70 percent in
healthy adults -- if the viruses selected to make the vaccine match the
viruses that emerge in a given year. Flu shot effectiveness can be substantially
lower in older adults with less responsive immune systems, but even so
the vaccine reduces severity of illness and can cut the risk of dying by
about 80 percent, according to the CDC.

"We can't promise it
will always prevent flu, but it does reduce deaths," says Dr. Ann
Thomas, public health physician with the Oregon Department of Human
Services.

The
more healthy adults and children immunized, the more difficult it is
for the virus to reach vulnerable people, and the more outbreaks are
minimized. That's why it's especially important to get a flu shot if you
care for an infant, patients in a hospital or nursing home, or anyone
with compromised immunity.

Pregnant women who get a flu shot
give protection to their newborns. Infants were less likely to be
infected with flu or hospitalized for respiratory illnesses in their
first six months of life if their mothers got a flu shot during
pregnancy, in a study tracking 1,169 women who gave birth during flu
season at the Navajo and White Mountain Apache Native American
reservations.

"We protect the weak by preventing illness among the strong," says Townes, the infectious disease specialist.

Does it matter when you get vaccinated?

"It's
good to get it as soon as it's available," says Thomas, the public
health physician. Immunity lasts for many months. Because flu activity
usually doesn't peak until February or March, Thomas says it's worth
getting vaccinated even if you put it off until after the holidays.

Who should get the new high-dose vaccine?

The
new Fluzone high-dose vaccine is intended for people 65 and older. It
contains four times the amount of immune-prompting antigen. In clinical
trials, the high-dose vaccine prompted a stronger immune response than
regular vaccine in older women and men. It remains to be seen whether
the improved immune response leads to greater protection. "The
downside," says Townes, "is there may be a slightly greater risk of a
local reaction." Until more is known, the regular flu shot remains a
perfectly good option for senior citizens.

Are there herbs or supplements that can prevent the flu?

None
has proved effective at preventing influenza in clinical trials. That
includes echinacea, elderberry, ginseng, or oscillococcinum. Studies
have shown that black elderberry syrup may shorten the duration of flu
symptoms by a few days in people who are already sick.

Are there other ways to avoid flu?

You
can avoid contact with the virus by washing your hands frequently and
using disinfectant wipes on shared telephones and computers.

Getting
a full eight hours of sleep can boost your immune system. Sleep
deprived volunteers in one study produced half the immune response to a
flu shot compared with those getting normal sleep.

If you smoke, you should quit. Smokers are more likely to contract the flu and more likely to die from its complications.

For
the sake of others, stay home if you have a cough and fever. Cover
coughs and sneezes with tissues or the crook of your arm -- not your
bare hands.